Order Instructions

To place your order, follow these steps:

  1. Download and complete the appropriate "electronic download" data request form from the table below.
  2. Save the completed form on your device.
  3. Send it to us using the upload feature at the bottom of this page. Make sure to hit "Send Message" when you are done.

Alternatively, you can print out the "paper download" form from the table below and fax it to us at 319-678-7856.

If you have any troubles at all with this process, please feel free to contact us using the form below or call us at 319-335-8618.

 Data Request Forms

Practice Form type Paper download link electronic download link
Physician, PA, and APN Data Request PDF PDF
  Roster Request PDF PDF

Data Request

  Roster Request PDF PDF
Pharmacy Data Request PDF PDF
  Roster Request PDF PDF



Mailing List
  • 1-1000 Names: $0.30/name
  • 1001+ Names: $0.20/name
  • (Minimum order $150.00)
  • Base Price: $150
  • Additional Copies: $35 each
  • Can be sorted by variable (e.g.: alpha, county, community, specialty)
  • Price: Varies
  • Features:
    • Complete current information
    • Data arrangement by geographic area or professional information by request
  • Price: Varies
  • Ideal data for tracking trends in Iowa health care (e.g.: research projects, planning efforts, random sample selection).

Fill Out the Form Below to Send Us Your Data Request

Maximum 5 files.
50 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, avi, mov, mp3, ogg, wav, bz2, gz, sit, svg, tar, zip.